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An Introduction to Economic Evaluation in Occupational Therapy: Cost-Effectiveness of Pre-Discharge Home Visits after Stroke (HOVIS)

2014; SAGE Publishing; Volume: 77; Issue: 7 Linguagem: Inglês

10.4276/030802214x14044755581664

1477-6006

Christopher Sampson, Marilyn James, Phillip Whitehead, Avril Drummond,

Acute Ischemic Stroke Management

Introduction: Occupational therapy interventions, such as home visits, have been identified as being resource-intensive, but cost-effectiveness analyses are rarely, if ever, carried out. We sought to estimate the cost-effectiveness of occupational therapy home visits after stroke, as part of a feasibility study, and to demonstrate the value and methods of economic evaluation. Method: We completed a cost-effectiveness analysis of pre-discharge occupational therapy home visits after stroke compared with a hospital-based interview, carried out alongside a feasibility randomized controlled trial. Our primary outcome was quality-adjusted life years. Full cost and outcome data were available for 65 trial participants. Findings: We found that the mean total cost of a home visit was £183, compared with £75 for a hospital interview. Home visits are shown to be slightly more effective, resulting in a cost per quality-adjusted life year of just over £20,000. Conclusion: Our analysis is the only economic evaluation of this intervention to date. Home visits are shown to be more expensive and more effective than a hospital-based interview, but our results are subject to a high level of uncertainty and should be treated as such. Further economic evaluations in this field are encouraged.